Technology Transfer in the Innovation Process CSAT Workforce Development Committee October 20, 2009 Heather Gotham, Ph.D. Evaluator, Mid-America ATTC Laurie Krom, M.S. Director, ATTC National Office Daniel Squires, Ph.D. Director, ATTC of New England Aaron Williams, M.A. Associate Director, Central East ATTC

Today’s Agenda The ATTC Network What is Technology Transfer?  A Brief History of the Field  The ATTC Technology Transfer Conceptual Model Using the ATTC Model  Example: Motivational Interviewing  Example: NIATx Technology Transfer: What does it really do and why should we care? Future Directions

The Addiction Technology Transfer Center (ATTC) Network

ATTC Network Established in 1993 by the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT) technology transfer“The purpose of this program is to develop and strengthen the workforce that provides addictions treatment services … the ATTCs assess the training and development needs of the substance use disorders workforce, and develop and conduct training and technology transfer activities to meet identified needs.” (2007 CSAT RFA)

5 ATTC Network

What is Technology Transfer?

A Brief History of the Field

Everett M. Rogers - Diffusion of Innovations First book, 1962 Popularized adoption curve Focused on diffusion up to decision to adopt Identified attributes of innovation that affected adoption Time Adoption

Where are we now?

ATTC Network Model of Technology Transfer in the Innovation Process

Development Creating and initially evaluating an innovation. *An innovation can be an idea, technology, treatment or method, including evidence-based practices.

TRANSLATION

Translation Explaining the essential elements and relevance of an innovation, then packaging it to facilitate dissemination.

DISSEMINATION

Dissemination Promoting awareness of an innovation with the goal of encouraging adoption and implementation. Dissemination strategies include raising awareness, building knowledge, and distributing materials.

ADOPTION

Adoption The process of deciding whether to use an innovation. Adoption may or may not lead to implementation.

Implementation Incorporating an innovation into routine practice. Implementation ideally includes a range of strategies designed to address individual, organizational, and systemic characteristics (e.g., skills training, administrative buy-in, and policy changes).

4 Most Important Things About Implementation that You Didn’t Learn in School 1.Dissemination is not implementation 2.Successful implementation takes 2-4 years 3.Training alone is never enough 4.Fidelity to evidence-based practices affects client outcomes

DIFFUSION

Diffusion The planned or spontaneous spread of an innovation.

MIAMIA STEP TECHNOLOGY TRANSFER

Technology Transfer A multidimensional process that intentionally promotes the use of an innovation. Begins during the development of an innovation, continues through its dissemination, and extends into its early implementation. Requires multiple stakeholders and resources, and involves activities related to the translation and adoption of an innovation. Accelerates the diffusion of an innovation.

ATTC Network Model of Technology Transfer in the Innovation Process

Using the ATTC Model

Innovation Example: Motivational Interviewing

Development Development of Motivational Interviewing (MI) Evidence-based counseling practice developed by William Miller and Stephen Rollnick (1991) Research shows that MI has a positive effect on retention in care (Carroll et al., 2006)* Carroll, K. M., ET.al., (2006). Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: A multisite effectiveness study., Drug and Alcohol Dependence, 81, Development

translated Examples of how the ATTC has translated MI ATTC Network, in conjunction with the NIDA Clinical Trials Network, develop the Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency product (MIA:STEP) Develop newsletters or articles that provide information about MI and the benefits of its use Translation

disseminated Examples of how the ATTC has disseminated MI ATTC Regional Centers conduct awareness and/or skill- building trainings with clinical staff around MI  From September 8, 2006 to present there have been a total of 538 events relating to MIA:STEP Blending Product 422 Pre-MIA:STEP, motivational interviewing events 422 Pre-MIA:STEP, motivational interviewing events Dissemination

adoption During the adoption process, the ATTC Network supports organizations and works to make sure they have the information necessary to “try on” MI so that they can authentically decide whether or not to implement the innovation. Adoption

Implementation Examples of how the ATTC supports implementation early implementation of MI ATTC Regional Centers provide training on the MIA:STEP product with clinical supervisors in order to sustain the use of MI in clinical settings ATTC Regional Centers provide ongoing technical assistance to program administrators around implementation ATTC Regional Centers provide periodic coaching sessions with clinical staff to enhance and refresh their MI skills

Innovation Example: NIATx Process Improvement

Development Development of the Innovation A process improvement innovation which includes strategies designed to improve an agency’s business practices, such as decreasing wait times translate Example of how the ATTC would translate NIATx strategies Develop products or other printed materials relevant to key stakeholders explaining the NIATx process in concrete terms

disseminate Example of how the ATTC would disseminate NIATx strategies Build support and understanding of the NIATx process with policymakers and key stakeholders through regular meetings and presentations adoption During the adoption process, the ATTC Network would support organizations and work to make sure they have the information necessary to “try on” NIATx strategies so that they can authentically decide whether or not to implement the innovation.

implementation Example of how the ATTC would support early implementation of a NIATx process improvement project Develop a learning community comprised of staff from various agencies that are implementing a NIATx process improvement project

Technology Transfer: What does it really do and why should we care?

DevelopmentDisseminationImplementation Copyright © 2006 ProjectCartoon.com. All Rights Reserved. Technology Transfer Accelerates the High Fidelity Diffusion of New Innovations

3-year follow-up study of clients with co-occurring mental illness & substance use disorders who received Assertive Community Treatment High Fidelity ACT team Low Fidelity ACT team Treatment Drop-outs 15%30% Substance Use in Remission 55%13% Hospital Admissions McHugo, 1999

The ATTC Technology Transfer Model Promotes: Standardized language Contextualized process –Helps partners to better understand and prepare for a multi-tiered process of change Focused purchasing power High fidelity change Greater satisfaction with the process

So What? Improves NOMs (e.g., improved services and outcomes) Happier workforce = less recidivism + increase recruitment Improves treatment outcomes and saves lives (e.g., EMMEE) Prepares the field by increasing capacity for ongoing changes (e.g., new EBPs; “pay for performance”)

Disseminating the Model Interactive section of the ATTC Network Website: ATTCnetwork.org/technologytransfer Academic journal Presentations The Bridge Network resources Ongoing partnerships Future Directions

Thank you for your time! Members of the ATTC Network Technology Transfer Workgroup Dan Squires, PhD, MPH (Co-chair) Heather Gotham, PhD Laurie Krom, MS Aaron Williams, MA Holly Hagle, MS Eric Hulsey, DrPH Nancy Roget, MS Pamela Waters, MEd